Parul Mohan MBBS, MD, Abstract Co-Author: Nothing to Disclose

Geeta Shroff MBBS, MD, Abstract Co-Author: Nothing to Disclose

Harsh Mahajan MD, MBBS, Presenter: Nothing to Disclose

Hypoxic brain injury is one of the major causes of cerebral palsy. Stem cell therapy has shown promise in clinical trials and is sought by many parents of children with cerebral palsy (CP). Brain perfusion studies with single photon emission computed tomography (SPECT) have been applied in these patients and have been evaluated either by visual interpretation or using semiquantitative analysis. Several processing protocols for 3D voxel-by-voxel analysis of brain perfusion SPECT have been applied, mainly the three-dimensional stereotactic surface projection (3DSSP) and the statistical parametric mapping (SPM) and recently the NeuroGam software. Although many studies have been published dealing with brain perfusion abnormalities in various neurological disorders, there is negligible literature concerning the interval changes in perfusion in cortical functional areas, pre and post therapy. The present study was to evaluate the treatment response (improvement or deterioration) in perfusion of specific areas of the brain cortex using Tc-HMPAO brain SPECT.

Sixty three patients (49 boys, 14 girls; age range 1 yr to 31 yr) with clinical manifestations of cerebral palsy underwent brain SPECT after intravenous injection of Tc-HMPAO. 

The results were elaborated as mild improvement when 10%- 30% changes were noted, moderate improvement when 30%-60% changes were noted and significant improvement when 60%-90% changes were noted. Thirty six patients had a normal brain SPECT after treatment. Seventeen patients had minimal residual hypoperfusion after treatment. The rest showed significant improvement after treatment with mild to moderate hypoperfusion. None of the patient in the series showed deterioration or no improvement.

Brain SPECT is an extremely useful tool in monitoring the treatment response to stem cell therapy in patients of cerebral palsy. It showed changes at the molecular level, hence indicating improvement even before the clinical changes were manifested. 

Brain SPECT showed changes at the molecular level, hence indicating improvement even before these changes became clinically apparant.

Mohan, P, Shroff, G, Mahajan, H, Serial Brain SPECT Imaging Using Neurogram Software to Monitor Treatment Response to Stem Cell Therapy in Patients with Cerebral Palsy.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13026088.html